Kornimate/medical-research-clean huggingface dataset:
language and lewy body diseases: sentence comprehension problems and modifying noninvasive brain stimulation treatment

Conditions: Lewy Body Disease; Healthy Aging

Summary: lewy body diseases (lbds) represents a group of neurodegenerative disorders characterized by the abnormal accumulation of aggregates of α-synuclein protein leading to the formation of lewy bodies (lb) and lewy neurites resulting in cell death. lbds consists of two major clinical entities - parkinson's disease (pd) and dementia with lb (dlb). vast majority of patients with lbds either already have mild cognitive impairment (mci) at the time of the diagnosis or will develop it during the course of the disease. language dysfunctions in lbds patients with mci are often unrecognized, which are difficult to treat, but even subtle changes might lead to impairment of social and occupational functioning with profound effect on their quality of lives. current pharmacological or surgical strategies are effective for tackling the motor issues of lbds with very limited effects on other symptoms such as language dysfunctions. therefore, non-pharmacological approaches are gaining more attention. one of these non-pharmacological strategies is the use of noninvasive brain stimulation (nibs) techniques that are able to modulate the brain functions with the effects on human nervous system plasticity. in this proposed project the investigators aim to first describe specific alterations in the language domain in lbds patients with mci as compared to healthy controls (hc) and identify the neural underpinnings of these changes using novel combination of advanced multimodal imaging techniques and various analytical methods. secondly, the investigators aim to use nibs as a supervised and individualized home-based therapeutical approach to tackle the language dysfunctions.


Eligibility criteria:
inclusion criteria: * right-handedness * czech as their first language * age (60-80 years) * presence of pd-mci (litvan et al. 2012) or mci-lb (mckeith et al. 2020) for lbd subjects exclusion criteria: * cardio pacemaker * any mri-incompatible metal in the body * epilepsy * any diagnosed psychiatric disorders * alcohol/drug abuse * for hc group the presence of lbds or other neurodegenerative disorder or mci/dementia
natural treatments for the management of emotional dysregulation in youth with non-verbal learning disability (nvld) and/or autism spectrum disorders (asd)

Conditions: Non-verbal Learning Disorder; Autism Spectrum Disorder; Autism

Summary: this study consists of a 6-week, open-label, randomized clinical trial study to compare efficacy and tolerability of the natural treatments omega-3 fatty acids, inositol, and n-acetylcysteine (nac) in the treatment of mood dysregulation in children and adolescents with non-verbal learning disability (nvld) or autism spectrum disorder (asd). subjects will include youth ages 5-17 years with a non-verbal learning disability (nvld) or autism spectrum disorder (asd) and current symptoms of emotional dysregulation.


Eligibility criteria:
inclusion criteria: * a previous established diagnosis of non-verbal learning disability (nvld) or dsm-v autism spectrum disorder and/ or combined t-scores on the child behavior checklist \> 195 on the withdrawn + social problems + thought problems subscales. * current symptoms of emotional dysregulation as indicated by combined t-scores on the child behavior checklist \> 180 on the anxiety/depression + aggression + attention subscales. * subjects and their caregivers must be english-speaking and have a level of understanding sufficient to communicate intelligently with the investigator and study coordinator, and to cooperate with all tests and examinations required by the protocol. * subjects and their caregivers must be willing and able to comply with all study procedures. * each subject and his/her authorized legal representative must understand the nature of the study. the subject's authorized legal representative must sign an informed consent document and the subject must sign an informed assent document. * subject must be able to swallow pills. * subject must have access to a computer with a camera, speaker, microphone, and internet connection. exclusion criteria: * investigator and his/her immediate family; defined as the investigator's spouse, parent, child, grandparent, or grandchild. * serious or unstable illness including hepatic, renal, gastroenterological, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, immunologic, or hematologic disease. * history of bleeding diathesis, including those with von willebrand disease. * uncorrected hypothyroidism or hyperthyroidism. * history of sensitivity to omega-3 fatty acids, inositol or nac. a non-responder or history of intolerance to omega-3 fatty acid, inositol or nac after 2 months of treatment at adequate doses as determined by the clinician. * severe allergies or multiple adverse drug reactions. * unstable or untreated seizure disorder. * dsm-iv substance use, abuse or dependence. * judged clinically to be at serious suicidal risk for c-ssrs score ≥ 4. * current diagnosis of schizophrenia. * current diagnosis or symptoms of psychosis. * iq \< 70. * pregnant or nursing. * weighs less than 12.5kg.

Keywords: autism learning disorder natural supplements nac omega-3
pilot feasibility trial of healthy beginnings for middle-aged, and older homeless women

Conditions: Homelessness; Health Promotion; Chronic Disease Self-care; Multimorbidity; Unhoused

Summary: this is a mixed methods pilot feasibility trial of healthy beginnings, an innovative, nurse-driven intervention. middle-aged and older, homeless women (mao-hw) will participate in the healthy beginnings intervention and select mao-hw will be invited to participate in post-intervention qualitative focus groups to evaluate the program.

this pilot feasibility trial will enroll middle-aged and older, homeless women (mao-hw) in the healthy beginnings intervention. participants will be asked to complete a baseline questionnaire and locator guide. participants will then engage over a period of approximately three months in nine 60-90 minute group sessions focused on health topics, and to meet with a research team member for six private sessions which will last up to 45 minutes each to assess the program and discuss content. fifteen participants will be asked to return at completion of the group/individual sessions to participate in a post-intervention qualitative focus group and follow-up questionnaire to evaluate the healthy beginnings intervention.

Eligibility criteria:
inclusion criteria: * self-reported age 40 years or older * sex assigned female at birth * homeless, or living in a shelter designed to provide transitional housing * self-reported multimorbidity (at least 2 physical/mental health conditions) * able to communicate in english exclusion criteria: * experiencing hallucinations * exhibiting signs of acute intoxication (e.g., slurred speech, pin-point pupils, difficulty walking) * non-english speaking * unable to understand study procedures (e.g., screening questions)

Keywords: middle-aged and older people experiencing homelessness women elderly trauma-informed care
neuromuscular adaptations to exercise in patients with type 2 diabetes mellitus

Conditions: Gait, Unsteady; Aerobic Exercise

Summary: the aim of this study is to compare the effects of high intensity interval exercise and moderate intensity continuous exercise on basic gait parameters in patients with type 2 diabetes mellitus.

volunteers with type 2 diabetes mellitus will be evaluated in terms of any contra-indication that will restrain them from making exercise. 90 male or female volunteers who are suitable in terms of inclusion/exclusion criteria will be invited for the study. volunteers will be randomly distributed to one of the 3 groups. each group will contain 30 participants. 1. group will make aerobic exercise which is in the form of high intensity interval exercise 2.group will make aerobic exercise which is in the form of moderate intensity continuous exercise 3. control group. exercise groups will be cycling under observation in the hospital setting. control group will make simple stretching exercises at home. participants will be requested to complete a 3 months of exercise. they will be evaluated before and at the end of the 3 months of exercise with basic gait parameters such as cadence, gait speed, stride length, percentages of swing phase and stance phase evaluated by a wireless digital miniature gait analysis system.

Eligibility criteria:
inclusion criteria: 1. participants must have type 2 diabetes mellitus less than 10 years and more than 1 year. 2. participants must have appropriate medical therapy and diet. 3. participants must not be treated with insulin. 4. participants must be exercising less than 210 minutes/ week exclusion criteria: 1. participants with prominent cardiovascular disease 2. participants with coronary artery disease 3. participants with moderate to severe valvular disease 4. participants with atrial fibrillation 5. participants with untreated hypertension 6. participants with congenital heart disease 7. participants with retinopathy 8. participants with neuropathy 9. participants with macro albuminuria 10. participants with cerebrovascular disease 11. participants with ejection fraction less than 40 12. participants with body mass index greater than 35. 13. participants with prominent ischemic changes in ekg at rest or during exercise. 14. participants with cigarette or alcohol addiction 15. participants on drugs that interferes with body fat distribution (such as insulin, thiazolidinediones

Keywords: type 2 diabetes mellitus exercise aerobic interval continuous gait
narrative therapy for treatment-resistant obsessive-compulsive disorder

Conditions: Obsessive-Compulsive Disorder

Summary: this is a prospective exploratory study using narrative therapy in group format, over 20 sessions, 2 hours per session, weekly, to determine whether this modality can provide any benefit to ocd symptoms, mood, sense of social connectedness, sense of identity, and/or quality of life in individuals living with treatment-resistant ocd. note: an amendment is now in place so that the group can occur virtually given the covid pandemic; zoom will be used as our platform.

many patients referred to the thompson centre at sunnybrook have severe ocd, and have significant and disabling symptoms even after completing our treatment protocols, including our intensive and residential programs. these patients have already undergone traditional cognitive behavioural therapy (cbt) and exposure and response prevention (erp), as well as pharmacotherapy. patients voice distress at their poor quality of life and high symptom burden, and can feel hopeless, if they have exhausted numerous evidence-based treatment options without significant improvement. narrative therapy is a unique approach, based on the premise that language reflects a social construction of reality. individuals with severe mental illness hold within themselves life narratives that reinforce their painful beliefs about themselves, the world, and others. evidence indicates that narrative therapy can help to create a more cohesive identity and a more flexible view of the self and the future. our primary goal is to determine whether narrative therapy could improve ocd symptom burden and quality of life in a highly treatment-resistant population. domains such as mood, identity, and interpersonal connectedness are secondary measures. the research questions are: could narrative therapy lead to symptomatic improvement in treatment-resistant ocd? and could narrative therapy improve the domains of mood, interpersonal connectedness, and/or identity in patients with treatment-resistant ocd?

Eligibility criteria:
inclusion criteria: * able to speak and write fluently in english. * patients who have participated in the intensive/residential program or group programs and/or have received pharmacotherapy with a psychiatrist at the frederick w. thomspon anxiety disorder centre * patients between the ages of 18-65 * only patients who have treatment-resistant ocd are eligible. for the purposes of this study we are defining this as: failure to achieve remission after having tried 1) at least two first-line ssri's and either clomipramine or atypical antipsychotic augmentation, and 2) at least one full course of exposure and response prevention (erp), or our intensive/residential program. exclusion criteria: * those with active substance abuse/dependence within three months * suspected organic pathology * recent suicide attempt/active suicidality * current self-injurious behaviour * active bipolar or psychotic disorder * history of aggression

Keywords: narrative therapy group therapy
changes of parameters of transcranial magnetic stimulation in patients with spinal cord injury

Conditions: Spinal Cord Injury

Summary: cns reorganization is evidenced in patients with cns lesion, no exception to the patients with spinal cord injury. the paraplegics have to increase their loading of upper extremities to compesate the lost function of lower extremities. we hypothesize that cns reorganization can happen in the chronic paraplegics. we try to compare the changes of parameters of transcranial magnetic stimulation in these patients with the normal population cross-sectionally.


Eligibility criteria:
inclusion criteria: * patients with complete thoracic spinal cord injury * onset \> 6 months * asia scale: a * normal bilateral upper extremities exclusion criteria: * evidence of brain injury * evidence of peripheral neuropathy * active major medical diseases (eg: fever, maligancies, dm, liver or kidney diseases)
effects of rtms based on brain activation during language performance in stroke patients with non-fluent aphasia

Conditions: Stroke; Aphasia

Summary: the aim of this study is to assess the safety and clinical efficacy of high or low-frequency repetitive transcranial magnetic stimulation based on brain activation with functional near infrared spectroscopy in poststroke nonfluent aphasia patients.

in poststsroke aphasia rehabilitation, repetitive transcranial stimulation (rtms) studies aimed to reinforce the activity of the brain regions in the left hemisphere. this goal can be achieved by using an excitatory protocol to reactivate the perilesional area or inhibitory protocol to reduce activities in the contralesional area. however, most conventional rtms studies employed an inhibitory low frequency protocol for the contralesional homologs of broca's area. in the present pilot study, investigators will perform functional near-infrared spectroscopy (fnirs) prior to rtms treatment for selection of the most appropriate application of stimulation. stimulation site and protocol (high frequency or low frequency rtms) will be determined by activation pattern from the fnirs findings with language task in individual patients.

Eligibility criteria:
inclusion criteria: * 18-80 yrs old * right-handed * radiologically confirmed left hemisphere stroke * fluent in korean * first ever stroke * more than 1 year from stroke onset * non-fluent (motor-dominant) aphasia * written informed consent exclusion criteria: * previous medical histories of stroke, cerebral vascular operation, seizure * patients with traumatic brain injury * unable to perform the language task * severe cognitive impairment (mmse less than 16) * skin lesion in the stimulation site of scalp * metal implants in the body (cardiac pacemaker or aneurysm clip) * pregnancy, breastfeeding
telemedicine vs. in-person delivery of cognitive behavioral treatment of insomnia: a mixed methods analysis

Conditions: Insomnia Disorder

Summary: cognitive behavioral therapy for insomnia (cbt-i) has been the 'gold standard' for the treatment of insomnia. there is a need to increase access to treatment, particularly for patients in more rural locations where providers may be scarce. one solution is to utilize telemedicine which is "the use of electronic communications to provide and support health care when distance separates the provider from the patient." so the purpose of the study is to determine if receiving cbt-i by video teleconferencing works just as well as in-person treatment.


Eligibility criteria:
inclusion criteria: * meet current dsm5 criteria for insomnia disorder as determined by clinician interview * isi score greater than 14, with self-reported duration of insomnia of at least 3 months * ability to read and speak english * own a personal computer with an internet connection sufficient to utilize the sleeptm and redcap platform * bmi less than 30 * between the ages of 21-50 exclusion criteria: * unable or unwilling to provide informed consent * individuals with an untreated sleep disorder other than insomnia (individuals with sleep apnea who are adherent with cpap treatment (average 4 hours use per night) will be eligible to participate) * a clinically unstable medical condition as defined by a new diagnosis or change in medical management in the previous 2 months * individuals with substance abuse/dependence, bipolar disorder, delirium, dementia, amnestic disorder, schizophrenia, and other psychotic disorders * individuals with prominent current suicidal or homicidal ideation * unable to perform tests due to inability to communicate verbally, inability to read and write; less than a 5th grade reading level; visual, hearing, or cognitive impairment * any use of medications or otc products that might impact sleep or metabolism

Keywords: cbt-i telemedicine
laser and microdermabrasion before photodynamic therapy for actinic keratoses in field-cancerized skin

Conditions: Actinic Keratosis; Sun Damaged Skin; Solar Keratosis; Solar Skin Damage

Summary: comparison of treatment efficacy and safety of pretreatment with ablative fractional laser versus microdermabrasion combined with large-area photodynamic therapy with methyl aminolevulinate for actinic keratoses

for each study participant, two test areas (a and b) are demarcated in the same anatomical region, with each area containing no less than 5 actinic keratoses (aks). test areas are randomized to receive skin pretreatment of either ablative fractional laser or microdermabrasion prior to photodynamic therapy using methyl aminolevulinate. efficacy, local skin reactions and safety of both test areas are evaluated over a 12-15 week follow up period.

Eligibility criteria:
inclusion criteria: * patients with two skin areas of at least 50 cm2 with a minimum of 5 actinic keratoses (aks) grade i-iii, chronically sun damaged "field" changes in one of the following anatomical regions: face, scalp, upper chest. * patients who have given written informed consent and are believed to be capable of following the study protocol. * fertile women must have a negative pregnancy test (urine-hcg) at the time of inclusion and use anti-contraception (oral contraceptives, intrauterine device, gestagen depot injection, subdermal implantation, vaginal ring, transdermal depot bandage or sterilisation) during the study. exclusion criteria: * patients that have within the last month received local treatment in the test areas. * pregnant or nursing patients. * patients with porphyria * patients with skin cancer, keratoacanthoma, or other infiltrating tumors within the test areas. * patients with a tendency to develop hypertrophic scars or keloids. * patients with a known allergy to metvix cream * patients that are believe unlikely to follow the study protocol.
restore: reducing future fractures and improving outcomes of fragility fracture

Conditions: Osteoporosis; Osteoporotic Fractures

Summary: restore tests whether augmented-fls, where patients are contacted by a patient navigator (serving as the liaison) and referred to a bone health provider, is better than enhanced usual care, which includes patient and pcp education and activation. we also aim to determine the influence of age, race, ethnicity, sex, poverty level, geographic region, and timing of entry into the trial after a fracture on the effectiveness of the two strategies.


Eligibility criteria:
inclusion criteria: * age 50 years and older (no upper age limit) * sustained a primary fragility fracture (hip/femur/pelvis, clinical spine, humerus, wrist/forearm) in the last 6 months * participant must self-identify a regular primary care provider (pcp) exclusion criteria: * exposure to the following medications in the prior 12 months * actonel or atelvia (risedronate) * fosamax or binosto (alendronate) * reclast, zometa, or aclasta (zoledronic acid, zoledronate) * boniva or bondronat (ibandronate) * aredia (pamidronate) * prolia (denosumab) * evenity (romozosumab) * tymlos (abaloparatide) * forteo (teriparatide) * natpara (parathyroid hormone) * evista (raloxifene) * miacalcin (calcitonin) * diagnosis of the following medical conditions * ckd stage 4 and above * paget's disease * multiple myeloma * osteomalacia * addison's disease * adrenal insufficiency * enrolled hospice care * solid organ transplant * bone marrow transplant * fractures resulting from severe trauma * scheduled appointment with a bone health clinician
gene therapy for x-linked chronic granulomatous disease (x-cgd)

Conditions: X-Linked Chronic Granulomatous Disease

Summary: x-linked chronic granulomatous disease (x-cgd) is a rare genetic disorder, which affects boys. it is caused by an error in a gene that makes part of the immune system. the basic defect lies in specialised white blood cells called phagocytic cells (or phagocytes), which are responsible for protection against infection by destroying invading bacteria and fungi. they do this by pouring large amounts of substances similar to bleach onto these organisms. in cgd, there is a defect in the system that makes the bleach, called the nadph-oxidase. in x-cgd (which accounts for two thirds of patients), the defect lies in a gene which makes up a critical part of the nadph-oxidase (known as gp91-phox), and the cells cannot make bleach-like substances. therefore they kill bacteria and fungi poorly, and the patients suffer from severe and recurrent infections. this also results in inflammation which can damage parts of the body such as the lung and gut. in many cases, patients can be adequately protected from infection by constant intake of antibiotics. however, in others, severe life-threatening infections break through. in some cases, inflammation in the bowel or urinary systems results in blockages which cannot be treated with antibiotics, and which may require the use of other drugs such as steroids. development of curative treatments for cgd is therefore of great importance.


Eligibility criteria:
inclusion criteria: * male x-cgd patients * molecular diagnosis confirmed by dna sequencing * at least one prior ongoing or resistant severe infection and/or inflammatory complications requiring hospitalisation despite conventional therapy * no hla-matched donor available after 3 months search unless the risk of waiting for a potential match or for performing an allogeneic transplant is considered unacceptable by the investigator exclusion criteria: * contraindication for leukapheresis * contraindication for administration of conditioning medication * administration of gammainterferon within 30 days before the infusion of transduced autologous cd34+ cells

Keywords: xcgd, lentivirus, cellular therapy